You are cracking me up!

High risk wedge crack.

Your teeth have cracks. It’s a fact.  Most cracks are in the enamel only and very rarely cause problems.  These are caused by temperature changes and biting forces in your mouth.  Most of the time you don’t even know they are there unless they are on a front tooth.

However, some cracks go into the inner tooth structure called dentin. Cracks in dentin are potential problems.  Since most of these cracks do not cause any discomfort or pain, it is important to have a dental professional evaluate them.  In our office we classify cracks into the dentin as low, medium and high risk.

Low risk cracks are straight up and down on the tooth, are not stained and follow the grooves of the tooth. These cracks we make note of and may take a picture in order to monitor it, but treatment is usually not needed.

Medium risk cracks often detour from the anatomy of the tooth. They may run diagonal across a tooth.  They can be associated with an older filling.  They are V-shaped and are wider at the top, and may be stained.  Medium risk cracks need to be evaluated individually.  If there is sensitivity or undermining of an existing filling, treatment is needed.  This treatment may be anywhere from a bite adjustment, to a small filling, to a full coverage crown.

High risk cracks often run diagonally across a tooth. They can emanate from a restoration. High risk cracks can have a halo of darkness around them indicating bacterial penetration (top right image).  Multiple cracks are a red flag, especially if they outline a cusp or biting surface of the tooth creating a wedge of unstable tooth (top left image).  High risk cracks need treatment.  These cracks will get larger over time.  As the cracks progress into the tooth, several things can happen.  The most common result of a high risk crack that is not treated is a broken tooth.  Hopefully that break leaves enough tooth to restore.  This almost always involves a full coverage crown.  The biggest risk is that the crack will proceed into the nerve area of the tooth.  This will cause sensitivity and then nerve damage that requires root canal therapy.  If unchecked, a high risk crack can fracture the tooth in half.  If this happens, the tooth is usually lost.

If we find a high risk crack on one of your teeth we will let you know what treatment we recommend. Often patients are reluctant to proceed because they do not have any symptoms or sensitivity.  Our experience with patients over the years is that these teeth will break at some point.    The problem is we don’t know if it will be tomorrow, next week or next year.  We just know it will break.

So if we start talking about a crack in your tooth, sit up and listen. If you don’t, the next time you see us, we could be explaining why that same tooth has to be extracted.

If we have already talked to you about a cracked tooth and you haven’t proceeded with our treatment recommendation, call us today. We are willing to give you a special offer just for reading this blog.

Thanks for reading,

Dr. Bruce

p.s. This dentist has an excellent YouTube video on cracked teeth: